Individual
BETHANY ROSE KUBNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3501 CRANBERRY BLVD, WESTON, WI 54476-5213
(715) 393-1000
Mailing address
3501 CRANBERRY BLVD, WESTON, WI 54476-5213
(715) 393-1000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10223-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40460100
—
WI
Enumeration date
10/04/2006
Last updated
05/12/2022
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